Champion Medical Supply LLC.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

CHAMPION MEDICAL SUPPLY LLC.

Practice address

1264 Ribaut Rd Ste 402
Beaufort, SC 29902-6129

Phone

(843) 470-3755

Fax

(843) 322-3203

NPI assigned

Apr 10, 2020

Last updated

Apr 10, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Paul Noles

Title

Coo

Phone

(478) 363-9250

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586476800000",
    "number": "1750900601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "463 POOLER PKWY # 163",
            "city": "POOLER",
            "state": "GA",
            "postal_code": "313225102",
            "telephone_number": "478-363-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 RIBAUT RD STE 402",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299026129",
            "telephone_number": "843-470-3755",
            "fax_number": "843-322-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION MEDICAL SUPPLY LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-10",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A",
        "authorized_official_last_name": "NOLES",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "478-363-9250"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "L.c@nationssleeps.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1264 Ribaut Rd Ste 402",
            "city": "Beaufort",
            "state": "SC",
            "country_code": "US",
            "postal_code": "299026129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Beaufort, SC
• Providers in Beaufort, SC by specialty
• Durable Medical Equipment & Medical Supplies in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.